Hepatotoksik Antibiyotikler

Year 2015, Volume: 8 Issue: 1, 65 - 73, 01.06.2015

Hakan Demir Yavuz Osman Birdane

Abstract

Tedavi sırasında ilacın en önemli yan etkilerinden biri karaciğer hasarıdır. Karaciğer, birçok ilaç ve değişik ajanların metabolizmasından sorumludur. İlaçların çoğu, intestinal emilimi kolaylaştıracak şekilde lipofilik yapıya sahiptir. İlaç, karaciğerde biyotransformasyon olarak bilinen, enzim sistemi aracılığıyla olan biyokimyasal olaylar ile safra ve idrardan atılımlarını mümkün kılan hidrofilik yapı kazanır. Biyotransformasyondan sorumlu ana organ olması karaciğeri aynı zamanda ilaç toksisitesinin hedefi haline getirir. Piyasada bulunan içlerinde çocuk ve yaşlı hastalarda da sıklıkla kullanılan antibiyotiklerin hepatotoksisite açısından önemli bir risk faktörü olduğu gözlenmiştir. Bu tür ilaçlar kullanılırken bu tehlike göz önünde bulundurulmalıdır. Enzim sisteminin genetik polimorfizmi, yaş cinsiyet farklılıkları, enfeksiyonlar, eşlik eden karaciğer hastalıkları ve birlikte kullanılan ilaçlar gibi nedenlerle aynı ilaca, eşit farmakolojik dozda verilmesine rağmen, kişiler farklı reaksiyon verebilirler. Karaciğer hasarı varlığında ise tedavide eliminasyonu öncelikle renal sistem üzerinden değişmemiş ilaç olarak yapılan antibiyotikler tercih edilmeli ve doz ayarlaması iyi yapılmalıdır.

Keywords

Antibiyotik, Hepatotoksisite, Karaciğer

Hepatotoxic Antibiotics

Abstract

Drug induced hepatotoxicity is one of the most important side effects in treatment. Liver is responsible for metabolism of many drugs and xenobiotics. Most drugs are lipophilic, enabling them to cross the membranes of intestinal cells. They gain a hydropylic structure through steps known as biotransformation by many enzyme systems in the liver. These transactions yields water soluble molecules and these are easily secreted in the urine or bile. Being the main organ of biotransformation, the liver is also the target organ for drug toxicity. The most handlig antibiotics in pediatric and geriatric clinical use are a big risc factor on hepatotoxiciy. Clinicians must be careful when using these antibiotics. Due to genetic polimorfizm of enzyme system, age, gender differences, infections, coexisting liver pathology and coadministered agents, different individuals exhibit different reactions to the same drug although given the same pharmacological doses. When liver injury exists, in the treatment the antibiyotics whose elimination has not been altered trough renal system should be chosen and the dose regulation should be done well.

Keywords

Antibiotic, Hepatotoxicity, Liver

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